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Article: Hospitalization and Mortality in Patients With Heart Failure Treated With Sacubitril/Valsartan vs. Enalapril: A Real-World, Population-Based Study

TitleHospitalization and Mortality in Patients With Heart Failure Treated With Sacubitril/Valsartan vs. Enalapril: A Real-World, Population-Based Study
Authors
Keywordsheart failure
sacubitril/valsartan
enalapril
pharmacoepidemiolgy
mortality
Issue Date2021
PublisherFrontiers Research Foundation. The Journal's web site is located at https://www.frontiersin.org/journals/cardiovascular-medicine
Citation
Frontiers in Cardiovascular Medicine, 2021, v. 7, p. article no. 602363 How to Cite?
AbstractBackground: The effect of sacubitril/valsartan on survival and hospitalization risk in older patients with heart failure has not been explored. We aimed to investigate the risk of hospitalization and mortality with the use of sacubitril/valsartan vs. enalapril in patients with heart failure. Methods: This was a population-based cohort study using the Hong Kong-wide electronic healthcare database. Patients diagnosed with heart failure and newly prescribed sacubitril/valsartan or enalapril between July 2016 and June 2019 were included. The risk of primary composite outcome of cardiovascular mortality or heart failure-related hospitalization, all-cause hospitalization, heart failure-related hospitalization, cardiovascular mortality and all-cause mortality were compared using Cox regression with inverse probability treatment weighting. Additional analysis was conducted by age stratification. Results: Of the 44,503 patients who received sacubitril/valsartan or enalapril, 3,237 new users (sacubitril/valsartan, n = 1,056; enalapril, n = 2,181) with a diagnosis of heart failure were identified. Compared with enalapril, sacubitril/valsartan users were associated with a lower risk of primary composite outcome [hazard ratio (HR) 0.58; 95% confidence interval (CI), 0.45-0.75], heart failure-related hospitalization (HR 0.59; 95% CI, 0.45-0.77), all-cause mortality (HR 0.51; 95% CI, 0.36-0.74) and borderline non-significant reductions in all-cause hospitalization (HR 0.85; 95% CI, 0.70-1.04) and cardiovascular mortality (HR 0.63; 95% CI, 0.39-1.02). The treatment effect of sacubitril/valsartan remains unaltered in the patient subgroup age ≥ 65 years (73%). Conclusions: In real-world settings, sacubitril/valsartan was associated with improved survival and reduced heart failure-related hospitalization compared to enalapril in Asian patients with heart failure. The effectiveness remains consistent in the older population.
Persistent Identifierhttp://hdl.handle.net/10722/301393
ISSN
2023 Impact Factor: 2.8
2023 SCImago Journal Rankings: 0.863
PubMed Central ID
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorPathadka, S-
dc.contributor.authorYan, VKC-
dc.contributor.authorLi, X-
dc.contributor.authorTse, G-
dc.contributor.authorWan, EYF-
dc.contributor.authorLau, H-
dc.contributor.authorLau, WCY-
dc.contributor.authorSiu, DCW-
dc.contributor.authorChan, EW-
dc.contributor.authorWong, ICK-
dc.date.accessioned2021-07-27T08:10:23Z-
dc.date.available2021-07-27T08:10:23Z-
dc.date.issued2021-
dc.identifier.citationFrontiers in Cardiovascular Medicine, 2021, v. 7, p. article no. 602363-
dc.identifier.issn2297-055X-
dc.identifier.urihttp://hdl.handle.net/10722/301393-
dc.description.abstractBackground: The effect of sacubitril/valsartan on survival and hospitalization risk in older patients with heart failure has not been explored. We aimed to investigate the risk of hospitalization and mortality with the use of sacubitril/valsartan vs. enalapril in patients with heart failure. Methods: This was a population-based cohort study using the Hong Kong-wide electronic healthcare database. Patients diagnosed with heart failure and newly prescribed sacubitril/valsartan or enalapril between July 2016 and June 2019 were included. The risk of primary composite outcome of cardiovascular mortality or heart failure-related hospitalization, all-cause hospitalization, heart failure-related hospitalization, cardiovascular mortality and all-cause mortality were compared using Cox regression with inverse probability treatment weighting. Additional analysis was conducted by age stratification. Results: Of the 44,503 patients who received sacubitril/valsartan or enalapril, 3,237 new users (sacubitril/valsartan, n = 1,056; enalapril, n = 2,181) with a diagnosis of heart failure were identified. Compared with enalapril, sacubitril/valsartan users were associated with a lower risk of primary composite outcome [hazard ratio (HR) 0.58; 95% confidence interval (CI), 0.45-0.75], heart failure-related hospitalization (HR 0.59; 95% CI, 0.45-0.77), all-cause mortality (HR 0.51; 95% CI, 0.36-0.74) and borderline non-significant reductions in all-cause hospitalization (HR 0.85; 95% CI, 0.70-1.04) and cardiovascular mortality (HR 0.63; 95% CI, 0.39-1.02). The treatment effect of sacubitril/valsartan remains unaltered in the patient subgroup age ≥ 65 years (73%). Conclusions: In real-world settings, sacubitril/valsartan was associated with improved survival and reduced heart failure-related hospitalization compared to enalapril in Asian patients with heart failure. The effectiveness remains consistent in the older population.-
dc.languageeng-
dc.publisherFrontiers Research Foundation. The Journal's web site is located at https://www.frontiersin.org/journals/cardiovascular-medicine-
dc.relation.ispartofFrontiers in Cardiovascular Medicine-
dc.rightsThis Document is Protected by copyright and was first published by Frontiers. All rights reserved. It is reproduced with permission.-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectheart failure-
dc.subjectsacubitril/valsartan-
dc.subjectenalapril-
dc.subjectpharmacoepidemiolgy-
dc.subjectmortality-
dc.titleHospitalization and Mortality in Patients With Heart Failure Treated With Sacubitril/Valsartan vs. Enalapril: A Real-World, Population-Based Study-
dc.typeArticle-
dc.identifier.emailYan, VKC: kcyan96@hku.hk-
dc.identifier.emailLi, X: sxueli@hku.hk-
dc.identifier.emailWan, EYF: yfwan@hku.hk-
dc.identifier.emailLau, WCY: wallisy@hku.hk-
dc.identifier.emailSiu, DCW: cwdsiu@hkucc.hku.hk-
dc.identifier.emailChan, EW: ewchan@hku.hk-
dc.identifier.emailWong, ICK: wongick@hku.hk-
dc.identifier.authorityLi, X=rp02531-
dc.identifier.authorityWan, EYF=rp02518-
dc.identifier.authoritySiu, DCW=rp00534-
dc.identifier.authorityChan, EW=rp01587-
dc.identifier.authorityWong, ICK=rp01480-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.3389/fcvm.2020.602363-
dc.identifier.pmid33553256-
dc.identifier.pmcidPMC7855850-
dc.identifier.hkuros323799-
dc.identifier.volume7-
dc.identifier.spagearticle no. 602363-
dc.identifier.epagearticle no. 602363-
dc.identifier.isiWOS:000614067700001-
dc.publisher.placeSwitzerland-

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